The Experts below are selected from a list of 798 Experts worldwide ranked by ideXlab platform
J. Charles Jennette - One of the best experts on this subject based on the ideXlab platform.
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Necrotizing Arteritis and Small Vessel Vasculitis
The Autoimmune Diseases, 2014Co-Authors: J. Charles Jennette, Ronald J. FalkAbstract:Publisher Summary There are three major categories of systemic vasculitis—namely, large vessel vasculitis or chronic granulomatous Arteritis, medium-sized vessel vasculitis or Necrotizing Arteritis, and small vessel vasculitis or Necrotizing polyangiitis. This chapter focuses on medium-sized vessel vasculitis and small vessel vasculitis. The evaluation of patients with cutaneous palpablepurpura revealed vasculitis involving predominantly small vessels. The pathologic findings in SVV of extensive acute inflammation with numerous neutrophils and conspicuous leukocytoclasia that resembled the Arthus reaction suggested a possible “hypersensitivity” pathogenesis. The chapter further discusses polyArteritis nodosa (PAN). The hallmark of PAN is Necrotizing inflammation of medium-sized or small arteries. Because different organs can be affected in different patients, the clinical manifestations of even relatively specific types of vasculitis are extremely variable among patients. Therefore, the diagnosis of systemic vasculitis, including autoimmune vasculitis, is difficult, and requires skillful integration of clinical, pathologic, and laboratory data. Although difficult, precise diagnosis is essential for proper management, because the prognosis and appropriate treatment vary substantially among different categories of vasculitis.
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CHAPTER 65 – Necrotizing Arteritis and Small Vessel Vasculitis
The Autoimmune Diseases, 2006Co-Authors: J. Charles JennetteAbstract:Publisher Summary There are three major categories of systemic vasculitis—namely, large vessel vasculitis or chronic granulomatous Arteritis, medium-sized vessel vasculitis or Necrotizing Arteritis, and small vessel vasculitis or Necrotizing polyangiitis. This chapter focuses on medium-sized vessel vasculitis and small vessel vasculitis. The evaluation of patients with cutaneous palpablepurpura revealed vasculitis involving predominantly small vessels. The pathologic findings in SVV of extensive acute inflammation with numerous neutrophils and conspicuous leukocytoclasia that resembled the Arthus reaction suggested a possible “hypersensitivity” pathogenesis. The chapter further discusses polyArteritis nodosa (PAN). The hallmark of PAN is Necrotizing inflammation of medium-sized or small arteries. Because different organs can be affected in different patients, the clinical manifestations of even relatively specific types of vasculitis are extremely variable among patients. Therefore, the diagnosis of systemic vasculitis, including autoimmune vasculitis, is difficult, and requires skillful integration of clinical, pathologic, and laboratory data. Although difficult, precise diagnosis is essential for proper management, because the prognosis and appropriate treatment vary substantially among different categories of vasculitis.
Ronald J. Falk - One of the best experts on this subject based on the ideXlab platform.
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Necrotizing Arteritis and Small Vessel Vasculitis
The Autoimmune Diseases, 2014Co-Authors: J. Charles Jennette, Ronald J. FalkAbstract:Publisher Summary There are three major categories of systemic vasculitis—namely, large vessel vasculitis or chronic granulomatous Arteritis, medium-sized vessel vasculitis or Necrotizing Arteritis, and small vessel vasculitis or Necrotizing polyangiitis. This chapter focuses on medium-sized vessel vasculitis and small vessel vasculitis. The evaluation of patients with cutaneous palpablepurpura revealed vasculitis involving predominantly small vessels. The pathologic findings in SVV of extensive acute inflammation with numerous neutrophils and conspicuous leukocytoclasia that resembled the Arthus reaction suggested a possible “hypersensitivity” pathogenesis. The chapter further discusses polyArteritis nodosa (PAN). The hallmark of PAN is Necrotizing inflammation of medium-sized or small arteries. Because different organs can be affected in different patients, the clinical manifestations of even relatively specific types of vasculitis are extremely variable among patients. Therefore, the diagnosis of systemic vasculitis, including autoimmune vasculitis, is difficult, and requires skillful integration of clinical, pathologic, and laboratory data. Although difficult, precise diagnosis is essential for proper management, because the prognosis and appropriate treatment vary substantially among different categories of vasculitis.
Izumi Nagata - One of the best experts on this subject based on the ideXlab platform.
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Subarachnoid hemorrhage from a ruptured anterior cerebral artery aneurysm caused by polyArteritis nodosa. Case report.
Journal of neurosurgery, 2002Co-Authors: Jun Takahashi, Nobuyuki Sakai, Koji Iihara, Hideki Sakai, Toshio Higashi, Shuji Kogure, Ayumi Taniguchi, Hatsue I. Ueda, Izumi NagataAbstract:PolyArteritis nodosa (PAN) is a rare systemic Necrotizing Arteritis that involves small- and medium-sized arteries in various organs. Although aneurysm formation in visceral arteries is a typical finding in PAN, intracranial aneurysms are much less common, and only a few cases of aneurysm rupture associated with this disease have been documented. In this paper, the authors report on a ruptured PAN aneurysm of the anterior cerebral artery; the lesion was trapped and resected. On histological examination, extensive fibrinoid necrosis and an inflammatory infiltration of leukocytes were seen in the aneurysm wall. To the authors' knowledge this is the first report of subarachnoid hemorrhage from a histologically confirmed PAN aneurysm.
John B. Imboden - One of the best experts on this subject based on the ideXlab platform.
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Neurologic Manifestations of Rheumatoid Arthritis.
Rheumatic diseases clinics of North America, 2017Co-Authors: Kimberly Dequattro, John B. ImbodenAbstract:Neurologic manifestations of rheumatoid arthritis (RA) range in severity from mild paresthesias in the hand from carpal tunnel syndrome to sudden death due to impingement of the medulla by an eroded, vertically subluxed dens. Most neurologic complications are a consequence of articular inflammation and damage that leads to compression of adjacent structures of the central or peripheral nervous systems. Rare but serious extra-articular manifestations include inflammation of the meninges and ischemic neuropathies due to Necrotizing Arteritis of the vasa vasorum. Medical therapy with synthetic disease-modifying antirheumatic drugs and biological agents has diminished the incidence of serious neurologic manifestations in RA.
Romain K. Gherardi - One of the best experts on this subject based on the ideXlab platform.
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Detection of genomic viral RNA in nerve and muscle of patients with HCV neuropathy
Neurology, 2003Co-Authors: François-jérôme Authier, Romain K. Gherardi, Loïc Guillevin, Guillaume Bassez, Christopher Payan, Jean-michel Pawlotsky, Jean-denis Degos, Laurent BélecAbstract:Background: Hepatitis C virus (HCV)–associated neuropathy is usually associated with mixed cryoglobulinemia (MC) and vasculitis. MC may contain viral RNA, and tissues showing vasculitis may contain intracellular HCV. Local HCV replication remains to be evidenced. Objective: To delineate the spectrum of HCV-associated neuropathy and to assess the presence of HCV in nerve and muscle tissues. Methods: Thirty consecutive HCV-infected patients with peripheral neuropathy were included. Genomic and replicative strands of HCV RNA were detected in both nerve and muscle biopsy samples using distinctive reverse transcription nested PCR. Results: Neuropathy was consistent with distal axonal polyneuropathy (DPN) in 25 of 30 patients, mononeuropathy multiplex (MM) in 3 of 30, and demyelinating polyneuropathy in 2 of 30. Pain was present in 18 of 30 patients and MC in 16 of 30. Biopsy showed inflammatory vascular lesions in 26 of 30 patients (87%), including Necrotizing Arteritis (6/30), small-vessel vasculitis (12/30) of either the lymphocytic (9/12) or the leukocytoclastic (3/12) type, and perivascular inflammatory infiltrates (8/30). All patients with Necrotizing Arteritis had DPN and positive MC detection. Both pain ( p p Conclusion: Painful DPN associated with MC and neuromuscular vasculitis is the most frequent type of HCV neuropathy. The usual detection of MC and the lack of local HCV replication indicate that HCV neuropathy results from virus-triggered immune-mediated mechanisms rather than direct nerve infection and in situ replication.
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The spectrum of vasculitis in human immunodeficiency virus-infected patients. A clinicopathologic evaluation.
Arthritis and rheumatism, 1993Co-Authors: Romain K. Gherardi, Laurent Bélec, Chokri Mhiri, Françoise Gray, M. C. Lescs, Alain Sobel, Loïc Guillevin, Janine WechslerAbstract:Objective. To delineate the different types of inflammatory vascular diseases (IVD) occurring in patients with human immunodeficiency virus (HIV) infection. Methods. Muscle, nerve, or skin biopsy specimens from 148 symptomatic HIV-infected individuals were reviewed, and subgroups of vasculitis were identified using the American College of Rheumatology (ACR) 1990 clinicopathologic criteria for the classification of vasculitis. Results. IVD was documented in 34 patients (23%) and included Necrotizing Arteritis (3 patients), non-Necrotizing Arteritis (1 patient), neutrophilic IVD (7 patients), mononuclear IVD (17 patients), and other small vessel inflammatory changes (6 patients). According to the ACR criteria, 11 patients could be classified as having a distinct category of vasculitis, including polyArteritis nodosa (4 patients), Henoch-Schonlein purpura (1 patient), and drug-induced hypersensitivity vasculitis (6 patients), and 23 were classified in the group ‘other vasculitis, type unspecified.’ One patient had hepatitis B virus surface antigenemia, 2 had cryoglobulinemia, and 2 were coinfected by human T lymphotropic virus type I. Cytomegalovirus inclusions and antigens were found in endothelial cells in 1 patient. HIV antigens and genome were detected in perivascular cells of 2 of the 3 patients with Necrotizing Arteritis; in 1, HIV-like particles were seen by electron microscopy. Immune deposits were found in small vessel walls in 5 skin biopsy samples showing small vessel vasculitis and in the muscle of the 3 patients with Necrotizing Arteritis. Conclusion. A wide range of inflammatory vascular diseases may occur in HIV-infected individuals. Vascular inflammation appears multifactorial and may result from HIV-induced immunologic abnormalities and exposure to a variety of xenoantigens, such as HIV itself, other infectious agents, and drugs.
